Progress in the elimination of hepatitis C virus infection: A population-based cohort study in Spain

Abstract

BackgroundThe World Health Organization set targets to eliminate hepatitis C virus (HCV) infection through detection and treatment of all cases by 2030. This study aimed to describe the progress and difficulties in the elimination of HCV infection in Navarra, Spain.MethodsUsing electronic healthcare databases, we performed a population-based prospective cohort study to describe changes in the prevalence of diagnosed active HCV infection at the beginning of 2015 and the end of 2017, the rate of new diagnoses and the rate of post-treatment viral clearance (PTVC) during this period.ResultsAt the beginning of 2015 there were 1503 patients diagnosed with positive HCV-RNA, 2.4 per 1000 inhabitants, and at the end of 2017 the prevalence had decreased by 47%. In the study period, 333 (18 per 100,000 person-years) new positive HCV-RNA cases were detected, but only 76 (23%; 4.2 per 100,000 person-years) did not have anti-HCV antibodies previously detected. Prevalent cases and new diagnoses of active infection were more frequent in men, people born in 1950–1979, HIV-infected patients and in those with lower income levels. Among patients with HCV-RNA, 984 achieved PTVC (22.7 per 100 person-years). PTVC was less frequent in patients born before 1940, in immigrants and in patients with lower income levels.ConclusionsThe prevalence of diagnosed active HCV infection has dropped by almost half over three years, because the number of patients with PTVC was much higher than the number of new diagnoses. Interventions specifically targeted at population groups with less favourable trends may be necessary.

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“…Not surprisingly, a lower prevalence was detected in the post‐alert cohort. However, it is consistent with the fact that the HCV seroprevalence decreases in time and that an increase in the number of unselected HCV serology requests after the recent emergence of direct‐acting antivirals and its immense pull effect may have decreased seroprevalence in the post‐alert cohort. However, this difference in the prevalence rate of both cohorts should not influence the results.…”

Modeling the Puzzle of Hepatitis C Epidemiology in Romania: A Pathway to Control

“…29 No 3: 377-384 countries [14,15], and in some countries outside Europe it is possible to find values between 7% to 8% [16]. However, successive epidemiological revisions have found lower HCV prevalence rates [17], whose values are between 0.2% and 1.5% in European countries [18].…”

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